Transcript Request Form
Office of Records & Registration
UWL charges a $10.00 fee for each set of transcripts (undergraduate and graduate records are considered one set).
Failure to complete this entire form may result in a delay in the issuance of your transcript.
Due to the Family Rights and Privacy Act of 1974, your signature is required for the release of a transcript.
For more transcript information or to order online: www.uwlax.edu/records/transcript-request-procedure/
Last Name: ______________________________________ First Name: ________________________________ MI: _________
Former Name(s): (please list ALL) _______________________________________________________________________________
Date of Birth (mm/dd/yyyy):_____________________________ ID Number (or SSN): __________________________________
Email: __________________________________________________________________ Phone: ________________________
Current Address: ___________________________________________________________________________________________
City: ____________________________________________ State: ___________________________ Zip code: ______________
Number of Copies: ________ ($10 per set) Status:
When to Send: First Term Enrolled: Year:
Last Term Enrolled: Year:
I hereby give consent to have my transcript released to the recipient(s) listed below.
Signature_____________________________________________________________________________________________________________________
Recipient Name & Address: Recipient Name & Address:
Special Instructions:
UW-La Crosse Records & Registration
Mail completed, signed form &
Attn: Transcripts
Questions?
records@uwlax.edu
check (payable to UW-La Crosse) to:
1725 State St
608.785.8576
La Crosse, WI 54601
Note: All transcripts sent to the students are stamped “issued to student”. Not all institutions (colleges, employers, etc.) will
accept these transcripts as official, even if they are in sealed envelopes. It is up to the student to verify with the receiver if
transcripts need to be sent directly from UWL.
currently enrolled at UWL
send immediately
fall
fall
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